Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02432 | Date 08/07/2019 |
| Token No | SM/18-19/4656 08/07/2019 | Serial | 023 |
| Patient Name | Mrs. PARBATI RAJBHAR | Contact No | NOT GIVEN |
| Address | PALBAGAN | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||